Tom Jaksic, MD, PHD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

51940 Issued in MA

Practice address

300 Longwood Ave
Fegan 3
Boston, MA 02115-5724

Phone

(617) 355-9600

Fax

(617) 730-0477

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General SurgeryAlso: Pediatric Medicine

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHMC Surgical Foundation IncGroup PAC ID 7012016488, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjaksic22115@direct.bostonchildrens.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CHMC Surgical Foundation Inc

  • Pediatric Surgery Physician
  • Boston, MA
  • NPI 1902977515
  Medicare reassignment Care Compare group NPD
• Childrens Hospital Boston

  dba Boston Medical Center

  • Children's Hospital
  • Boston, MA
  • NPI 1770741530
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1972538379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 TEMPLE ST UNIT 510",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144273",
            "telephone_number": "617-840-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "FEGAN 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-9600",
            "fax_number": "617-730-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKSIC",
        "first_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "51940",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MA",
            "license": "51940",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MA",
            "license": "51940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael T Jaklitsch, MD
• Kristina Ann Jakobson
• Bernadette V Jakomin, M.D.
• Natnicha Jakramonpreeya, MD
• Alexander James Jaksic, MD
• Alex Jakubiak, MD
• Abdullah Jalal, MD
• Lauren Jalali, MS, RD, LDN
• Zahra Jalali, MD
• Marla Jalbut, MD

• Pediatric Surgery Physician in Boston, MA
• Providers in Boston, MA by specialty
• Pediatric Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.